TY 2017 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) KATHRYN MARY JOHNSON...................................................................... PRESIDENT	5.00 .................	X	X	0	0
(2) MIKE STRAUSS...................................................................... VICE PRESIDE	3.00 .................	X	X	0	0
(3) ILDIKO TODOROVIC...................................................................... SECRETARY	3.00 .................	X	X	0	0
(4) MARLENE DOMASH...................................................................... TREASURER	3.00 .................	X	X	0	0
(5) MELINDA BUSH...................................................................... DIRECTOR	2.00 .................	X		0	0
(6) MICHAEL ROSENGARDEN...................................................................... DIRECTOR	2.00 .................	X		0	0
(7) JOBY ORLOWSKY...................................................................... DIRECTOR	2.00 .................	X		0	0
(8) JONATHON HUGHES...................................................................... DIRECTOR	2.00 .................	X		0	0
(9) JANE KIERNAN...................................................................... DIRECTOR	2.00 .................	X		0	0
(10) JEREMY FAUST...................................................................... DIRECTOR	2.00 .................	X		0	0
(11) JOYCE MASON...................................................................... DIRECTOR	2.00 .................	X		0	0
(12) CHRIS PALMER...................................................................... DIRECTOR	2.00 .................	X		0	0
(13) MOHAN RAMALINGAM...................................................................... DIRECTOR	2.00 .................	X		0	0
(14) KEVIN STEVENS...................................................................... DIRECTOR	2.00 .................	X		0	0
(15) MARY TURLEY...................................................................... DIRECTOR	2.00 .................	X		0	0
(16) PAT DAVENPORT...................................................................... EX DIR/CEO	60.00 .................		X	114,186	13,098
(17) GARY POTTER...................................................................... CFO	50.00 .................		X	95,449	817

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

LAKE COUNTY CRISIS CENTER

Employer identification number

36-3032700

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	2,223,235	2,256,431	2,296,207	2,732,783	3,779,352	13,288,008
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3	2,223,235	2,256,431	2,296,207	2,732,783	3,779,352	13,288,008
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..						171,690
6	Public support. Subtract line 5 from line 4.						13,116,318

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
7	Amounts from line 4..	2,223,235	2,256,431	2,296,207	2,732,783	3,779,352	13,288,008
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	8,178	8,219	8,229	8,208	8,180	41,014
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..	292,367	331,549	113,429	142,706	146,099	1,026,150
11	Total support. Add lines 7 through 10						14,355,172

Gross receipts from related activities, etc. (see instructions) ..................

275,646

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

91.370 %

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

89.990 %

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2019 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
PART II, LINE 10	COURT FEES 20,862 INSURANCE REIMBURSEMENT 59 ABUSER SERVICE FEES 83,570 SUPPORTIVE HOUSING RENTS 456,937 VISITATION AND EXCHANGE FEE 10,716 DOMESTIC VIOLENCE TRAINING 2,195 GROSS RECEIPTS FROM SPECIAL EVENTS 437,655 OTHER 14,156

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

LAKE COUNTY CRISIS CENTER

Employer identification number

36-3032700

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization LAKE COUNTY CRISIS CENTER

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization LAKE COUNTY CRISIS CENTER		Employer identification number 36-3032700

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization LAKE COUNTY CRISIS CENTER			Employer identification number 36-3032700
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

LAKE COUNTY CRISIS CENTER

Employer identification number

36-3032700

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	5,000	5,000	5,000	5,000	5,000
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	5,000	5,000	5,000	5,000	5,000

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

100.000 %

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	210,465		210,465
b	Buildings ....	5,605,994	2,102,585	3,503,409
c	Leasehold improvements
d	Equipment ....
e	Other .....	1,002,036	687,576	314,460
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				4,028,334

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	8,109
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	3,870,873
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	2,562
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................			2e	2,562
3	Subtract line 2e from line 1..................			3	3,868,311
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	3,868,311

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1	3,542,734
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3	3,542,734
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	3,542,734

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization
LAKE COUNTY CRISIS CENTER

Employer identification number

36-3032700

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2019

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 UNMASK VIOLENCE (event type)	(b) Event #2 WINE, WOMEN & S (event type)	(c) Other events 1 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	201,613	141,524	66,276	409,413
2	Less: Contributions . . . .	166,613	113,524	52,776	332,913
3	Gross income (line 1 minus line 2) . . . . . .	35,000	28,000	13,500	76,500

4	Cash prizes . . . . .
5	Noncash prizes . . . .	2,685	1,529	5,879	10,093
6	Rent/facility costs . . . .		38,223	4,166	42,389
7	Food and beverages . . .	58,630			58,630
8	Entertainment . . . .	2,350	1,850	730	4,930
9	Other direct expenses . . .	25,648	45,090	8,392	79,130
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				195,172
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-118,672

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2019

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

LAKE COUNTY CRISIS CENTER

Employer identification number

36-3032700

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...	X	1,020	22,053	APPROXIMATE RETAIL VALUE
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( SOFTWARE )	X	2	19,394	APPROXIMATE RETAIL VALUE
26 Other ( MATERIALS )	X	3	22,844	APPROXIMATE RETAIL VALUE
27 Other ( FURNITURE )	X	250	45,000	APPROXIMATE RETAIL VALUE
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2019)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE M, PAGE 2, PART II	PART I, COLUMN B SHOWS THE NUMBER OF CONTRIBUTIONS WITH THE EXCEPTION OF LINE 26. LINE 26, COLUMN B SHOWS THE NUMBER OF PIECES OF FURNITURE DONATED.

Schedule M (Form 990) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

LAKE COUNTY CRISIS CENTER

Employer identification number

36-3032700

Return Reference	Explanation
FORM 990	ORGANIZATION MISSION - (CONTINUED FROM FORM 990, PAGE 1, PART 1, LINE 1 AND FROM FORM 990, PAGE 2, PART III, LINE 1) ADVOCATE FOR ELIMINATING DOMESTIC VIOLENCE IN NORTHERN ILLINOIS, A SAFE PLACE OFFERS COMPREHENSIVE SERVICES THAT PROVIDE A SAFETY NET TO ASSIST VICTIMS OF DOMESTIC VIOLENCE, HUMAN TRAFFICKING AND THEIR CHILDREN. SERVICES ARE DESIGNED TO MEET THE IMMEDIATE CRISIS AND LONG-TERM NEEDS OF VICTIMS OF VIOLENCE AND THEIR CHILDREN, TO PREVENT FUTURE VIOLENCE, AND TO HELP SURVIVORS ACHIEVE SELF- SUFFICIENCY. THE CONTINUUM OF SERVICES PROVIDED FOR VICTIMS OF VIOLENCE INCLUDES: A 24-HOUR CRISIS LINE A 24 HOUR ON-CALL CRISIS RESPONSE SERVICES WITH LAW ENFORCEMENT CASE MANAGEMENT A 24-HOUR EMERGENCY SHELTER, 33 TRANSITIONAL HOUSING UNITS 37 PERMANENT SUPPORTIVE HOUSING UNITS FAMILY, INDIVIDUAL AND GROUP COUNSELING, THERAPY AND ART THERAPY LEGAL ADVOCACY PROGRAM THAT PROVIDES ASSISTANCE WITH ORDERS OF PROTECTION SAFE CUSTODY EXCHANGES SUPERVISED CHILD VISITATIONS LIFE SKILLS EMPLOYMENT, FINANCIAL LITERACY AND BUDGETING ADVOCACY EDUCATION OUTREACH SUPPORTIVE SERVICES SAFE YOUTH INITIATIVE, WHICH IS A VIOLENCE PREVENTION AND INTERVENTION PROGRAM MENTORING PROGRAM FOR ADOLESCENT BOYS TO PREVENT VIOLENCE FROM CONTINUING IN THE NEXT GENERATION AN INTERVENTION PROGRAM FOR PERPETRATORS OF ABUSE, TEACHING THEM ACCOUNTABILITY AND HELPING THEM TO EXAMINE AND CHANGE THEIR ABUSIVE BEHAVIORS OVER THE COURSE OF A SIX-MONTH PROGRAM.
FORM 990, PAGE 2, PART III, LINE 4A	ON DOMESTIC VIOLENCE AND OUR SERVICES. DURING THE YEAR, WE HELPED 1,519 CALLERS TO OUR CRISIS LINE WITH SUPPORTIVE/CARING LISTENING/COUNSELING, INFORMATION, REFERRALS, AND ADVICE.
FORM 990, PAGE 2, PART III, LINE 4D	FAMILY VISITATIONS AND EXCHANGES - A SAFE PLACE'S FAMILY VISITATION CENTER SUPERVISED AND FACILITATED 1,270 CUSTODY EXCHANGES AND 1,003 VISITATIONS, WITH SAFETY OF CHILDREN AND SURVIVORS AS THE PRIMARY CONCERN. DURING THE YEAR, 116 FAMILIES (WITH 184 CHILDREN) WERE SERVED. 81% OF CASES INVOLVE FAMILIES IMPACTED BY DOMESTIC VIOLENCE, WITH THE MAJORITY OF THE REMAINING FAMILIES IMPACTED BY CHILD ABUSE. (OTHER CASES INVOLVE SEXUAL ASSAULT AND STALKING. LEGAL ADVOCACY - OUR LEGAL ADVOCACY PROGRAM, LOCATED IN THE LAKE COUNTY COURTHOUSE PROVIDED ASSISTANCE TO 1,724 SURVIVORS SEEKING ORDERS OF PROTECTION FOR DOMESTIC VIOLENCE. OUR LEGAL ADVOCACY TEAM ASSISTED SURVIVORS IN OBTAINING 1417 EMERGENCY, 8 INTERIM AND 9 PLENARY DOMESTIC VIOLENCE ORDERS OF PROTECTION. IN ADDITION, WE ASSISTED 600 PEOPLE TO OBTAIN ORDERS OF PROTECTION RELATED TO SEXUAL ASSAULT, AND STALKING/NO- CONTACT. THROUGH THE STAFF, INCLUDING SEVERAL VOLUNTEERS, OVER 2,547 HOURS OF ADVOCACY WAS PROVIDED TO SURVIVORS. OUTREACH & EDUCATION - WE WORK TO EDUCATE THE COMMUNITY ABOUT THE DYNAMICS AND EFFECTS OF DOMESTIC VIOLENCE, AND ADVOCATE FOR SURVIVORS, WHILE RAISING AWARENESS OF THE SERVICES THAT ARE AVAILABLE THROUGH MULTIPLE OUTREACH EFFORTS BY STAFF MEMBERS DEDICATED TO OUR EDUCATION PROGRAMS AS WELL AS THROUGH STAFF MEMBERS FROM EVERY AREA OF OUR AGENCY. EDUCATION AND OUTREACH ARE PROVIDED AT BUSINESSES, RELIGIOUS INSTITUTIONS AND OTHER COMMUNITY GATHERINGS. WE ALSO EDUCATE PROFESSIONALS SUCH AS SOCIAL WORKERS OR LAW ENFORCEMENT OFFICIALS WHO MAY COME IN CONTACT WITH DOMESTIC VIOLENCE SURVIVORS. WE PROVIDED OVER 463 HOURS OF EDUCATION AND TRAINING THROUGH 295 PRESENTATIONS REACHING 16,353 PEOPLE. TO ADDRESS THE ISSUES OF TEEN DATING VIOLENCE, A SAFE PLACE ALSO FACILITATES HEALTHY DATING PRESENTATIONS AT LOCAL SCHOOLS AND AGENCIES TO EDUCATE YOUTH AND TEENS. 23 OF THESE PRESENTATIONS, WHICH WORK TO PREVENT DOMESTIC VIOLENCE THROUGH EDUCATION ON RED FLAGS, ABUSIVE DYNAMICS AND THE OPTIONS AVAILABLE FOR TEENS, WERE PROVIDED TO 812 YOUTHS DURING THE YEAR. ABUSER SERVICES - IPDAV - WE ALSO WORK TO ELIMINATE DOMESTIC VIOLENCE AND INCREASE THE SAFETY OF SURVIVORS BY WORKING DIRECTLY WITH ABUSERS. OUR ABUSER INTERVENTION PROGRAM PROVIDED 2,388 HOURS OF COUNSELING THROUGH A SIX-MONTH PROGRAM TO 79 PERPETRATORS OF ABUSE, TEACHING THEM ACCOUNTABILITY AND HELPING THEM TO EXAMINE AND CHANGE THEIR ABUSIVE BEHAVIORS. EACH PARTICIPANT IS INDIVIDUALLY ASSESSED BEFORE BEING PLACED INTO A WEEKLY GROUP. 77 CLIENTS RECEIVED VIOLENCE/BEHAVIORAL ASSESSMENTS DURING THE YEAR. VIOLENCE PREVENTION - SAFE YOUTH, SAFER LAKE COUNTY - THROUGH THE SAFE YOUTH-SAFER LAKE COUNTY PROGRAM, EDUCATION OUTREACH COORDINATORS, THERAPISTS, AND CASE MANAGERS PROVIDE SPECIALIZED VIOLENCE REDUCTION SERVICES TO WAUKEGAN MIDDLE- AND HIGH-SCHOOL STUDENTS. DURING THE YEAR, SAFE YOUTH OFFERED SERVICES IN 5 MIDDLE SCHOOLS AND 2 HIGH SCHOOLS TO PROVIDE 7,101 STUDENTS WITH PREVENTION EDUCATION FOCUSING ON: HEALTHY RELATIONSHIPS/TEEN DATING VIOLENCE; DECISION MAKING/DRUGS AND ALCOHOL; AND INTERNET SAFETY. AS A RESULT OF THIS PREVENTION EDUCATION, 106 CHILDREN RECEIVED BEHAVIORAL HEALTH SERVICES, 41 CHILDREN RECEIVED STREET INTERVENTION/INTERRUPTION SERVICES AND 162 RECEIVED RESOURCES AND ADVOCACY THROUGH CASE MANAGEMENT SERVICES. THROUGH PUBLIC AWARENESS EFFORTS THROUGHOUT THE COMMUNITY, WE MADE CONTACT WITH 45,506 COMMUNITY MEMBERS TO EDUCATE THEM ABOUT VIOLENCE PREVENTION, HEALTHY RELATIONSHIPS, AND THE SAFE YOUTH-SAFER LAKE COUNTY SERVICES BEING OFFERED IN THE WAUKEGAN MIDDLE AND HIGH SCHOOLS.
FORM 990, PAGE 6, PART VI, LINE 6	PER BY-LAWS - THE GENERAL MEMBERSHIP SHALL CONSIST OF INDIVIDUALS AND COMMUNITY GROUPS INTERESTED IN AND WHO CONTRIBUTE FINANCIALLY, OR IN-KIND, TO THE ANNUAL OPERATION OF THE ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 7A	FROM BY-LAWS - DIRECTORS SHALL BE ELECTED BY THE GENERAL MEMBERSHIP AT THE ANNUAL MEETING OF THE MEMBERS. EACH MEMBER PRESENT AT A MEETING, EITHER IN PERSON OR BY PROXY, SHALL BE ENTITLED TO ONE VOTE ON EACH MATTER SUBMITTED TO A VOTE OF THE MEMBERS.
FORM 990, PAGE 6, PART VI, LINE 11B	THE FINANCE COMMITTEE (COMPRISED OF BOARD MEMBERS) REVIEWS THE COMPLETED FORM 990 AND, AFTER MAKING ANY NECESSARY CHANGES, APPROVES FORWARDING TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS IS PROVIDED WITH THE DRAFT FORM 990 IN ADVANCE OF THEIR NEXT SCHEDULED OR SPECIAL MEETING AND, AT THEIR MEETING, ASK QUESTIONS AND DISCUSSES THE 990 DRAFT. AFTER MAKING ANY NEEDED CHANGES, THE BOARD GIVES FINAL APPROVAL FOR FILING WITH THE IRS.
FORM 990, PAGE 6, PART VI, LINE 12C	IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. IN ADDITION, ALL INTERESTED PERSONS MUST COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE (PRIOR TO) UPON BECOMING AN OFFICER OR UPON JOINING THE BOARD OF DIRECTORS OR ANY COMMITTEE AND AT LEAST ANNUALLY THEREAFTER. THE EXECUTIVE DIRECTOR WILL ENSURE THAT THIS TAKES PLACE AND BRING ANY POTENTIAL CONFLICTS TO THE EXECUTIVE COMMITTEE'S ATTENTION.
FORM 990, PAGE 6, PART VI, LINE 15A	THE EXECUTIVE COMMITTEE OF THE BOARD MEETS INDEPENDENTLY OF THE EXECUTIVE IN QUESTION, AND FOLLOWS A RIGOROUS PROCESS, DOCUMENTING ALL OF THE FOLLOWING IN WRITTEN FORM: 1) REVIEW OF WRITTEN JOB DESCRIPTION, MAKING ANY NECESSARY CHANGES; 2) INPUT IS SOUGHT FROM BOTH THE EXECUTIVE DIRECTOR, BOARD MEMBERS, AND EXECUTIVE STAFF, INASMUCH AS IT RELATES TO THE EXECUTIVE'S JOB PERFORMANCE; 3) INPUT IS SOUGHT FROM THE EXECUTIVE WHOSE COMPENSATION IS BEING DETERMINED; 4) INPUT IS SOUGHT FROM THE HR MANAGER; 5) THE COMMITTEE SEEKS OUT SALARY SURVEY INFORMATION AND/OR COLLECTS RELEVANT DATA FROM AREA ORGANIZATIONS OF THE SAME SIZE; 6) THE EXECUTIVE COMMITTEE VOTES ON ANY COMPENSATION CHANGES AND MEETS WITH THE EXECUTIVE.
FORM 990, PAGE 6, PART VI, LINE 15B	THE EXECUTIVE COMMITTEE OF THE BOARD MEETS INDEPENDENTLY OF THE EXECUTIVE IN QUESTION, AND FOLLOWS A RIGOROUS PROCESS, DOCUMENTING ALL OF THE FOLLOWING IN WRITTEN FORM: 1) REVIEW OF WRITTEN JOB DESCRIPTION, MAKING ANY NECESSARY CHANGES; 2) INPUT IS SOUGHT FROM BOTH THE EXECUTIVE DIRECTOR, BOARD MEMBERS, AND EXECUTIVE STAFF, INASMUCH AS IT RELATES TO THE EXECUTIVE'S JOB PERFORMANCE; 3) INPUT IS SOUGHT FROM THE EXECUTIVE WHOSE COMPENSATION IS BEING DETERMINED; 4) INPUT IS SOUGHT FROM THE HR MANAGER; 5) THE COMMITTEE SEEKS OUT SALARY SURVEY INFORMATION AND/OR COLLECTS RELEVANT DATA FROM AREA ORGANIZATIONS OF THE SAME SIZE; 6) THE EXECUTIVE COMMITTEE VOTES ON ANY COMPENSATION CHANGES AND MEETS WITH THE EXECUTIVE.
FORM 990, PAGE 6, PART VI, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST BY WRITTEN REQUEST AND/OR REVIEW ON THE ORGANIZATION'S PREMISES.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

LAKE COUNTY CRISIS CENTER

Employer identification number

36-3032700

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) A SAFE PLACE II LP 2710 17TH STREET ZION,IL60099 26-3815945	LOW INC HS	IL	272889301	RELATED	-15	59,005	Yes			Yes		0.010 %
(2) A SAFE PLACE II DEVELOPMENT GP LLC 2710 17TH STREET ZION,IL60099 27-2889301	LOW INC HS	IL	263815871	RELATED	-15	59,005		No		Yes		0.510 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) A SAFE PLACE II DEVELOPMENT CORP 2710 17TH STREET ZION,IL60099 26-3815871	LOW INC HS	IL	NA	C CORP	-15	126,880	100.000 %		No

Schedule R (Form 990) 2019

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) A SAFE PLACE II LP	A	8,010	ACTUAL AMOUNT
(2) A SAFE PLACE II LP	D	25,000	ACTUAL AMOUNT

Schedule R (Form 990) 2019

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference

Explanation

SCHEDULE R

DURING FY2009, LAKE COUNTY CRISIS CENTER - A SAFE PLACE ("THE ORGANIZATION") APPROVED PLANS TO BUILD A PERMANENT SUPPORTIVE HOUSING FACILITY IN ZION, ILLINOIS. "A SAFE PLACE II DEVELOPMENT CORP." ("THE DEV. CORP."), OF WHICH THE ORGANIZATION IS THE SOLE SHAREHOLDER, IS AN ILLINOIS NOT-FOR-PROFIT CORPORATION, TAXED AS A C CORPORATION AND WAS FORMED TO OVERSEE THE PROJECT. DURING FY2010, A NEW LLC WAS FORMED, A SAFE PLACE II DEVELOPMENT GP, LLC. THE DEV. CORP. IS A 51% CO-MANAGING MEMBER OF THE NEW LLC, WHICH IS A GENERAL PARTNER WITH A .01% INTEREST IN A SAFE PLACE II LP, A LIMITED PARTNERSHIP FORMED TO FINANCE AND OPERATE A 20-UNIT LOW-INCOME PERMANENT SUPPORTIVE HOUSING PROJECT FOR VICTIMS OF DOMESTIC VIOLENCE AND THEIR CHILDREN. DURING FY2011, THE PROJECT FINALIZED FINANCING AND SUBSTANTIALLY COMPLETED THE CONSTRUCTION OF THE BUILDING, WHICH OPENED IN JULY 2011. THE FACILITY (OPENED IN JULY 2011) HOUSES 20 FAMILIES IN SAFE & AFFORDABLE HOUSING, WITH ON-SITE SUPPORTIVE SERVICES PROVIDED BY LAKE COUNTY CRISIS CENTER - A SAFE PLACE FOR THE VICTIMS OF DOMESTIC ABUSE THAT LIVE IN THE UNITS, THUS FURTHERING OUR EXEMPT PURPOSE AS AN ORGANIZATION.

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,732,783	3,779,352
9	Program service revenue (Part VIII, line 2g) .........	177,509	198,896
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	8,208	1,166
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-153,035	-111,103
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	2,765,465	3,868,311
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	1,578,470	2,277,669
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 360,838
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	897,030	1,265,065
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,475,500	3,542,734
19	Revenue less expenses. Subtract line 18 from line 12.......	289,965	325,577
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	5,226,659	5,714,038
21	Total liabilities (Part X, line 26).............	1,292,469	1,451,709
22	Net assets or fund balances. Subtract line 21 from line 20.....	3,934,190	4,262,329

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 728,295 including grants of $ ) (Revenue $ )
	SHELTER & CRISIS ADVOCACY - WE PROVIDED 6,634 NIGHTS OF EMERGENCY SHELTER TO 77 ADULTS AND 57 CHILDREN. THIS INCLUDED DOMESTIC VIOLENCE SURVIVORS WHO STAYED AT THE SHELTER FACILITY AS WELL AS 32 SURVIVORS AND THEIR CHILDREN WHO RECEIVED 462 NIGHTS OF SHELTER AT LOCAL HOTELS. (HOTEL SHELTER IS PROVIDED WHEN THERE IS NO ROOM AT THE AGENCY'S 33-BED EMERGENCY SHELTER.) WHILE AT THE SHELTER, SURVIVORS AND THEIR CHILDREN RECEIVE COUNSELING AND ADVOCACY SERVICES AS WELL AS FOOD, CLOTHING, AND OTHER BASIC NEEDS. A SAFE PLACE ALSO OPERATES A 24-HOUR CRISIS LINE OUT OF THE EMERGENCY SHELTER, ALSO PROVIDING IMMEDIATE IN-PERSON CRISIS COUNSELING FOR THOSE IN IMMEDIATE DANGER. SUPPORT IS AVAILABLE ANY TIME, DAY OR NIGHT, FOR SURVIVORS IN CRISIS OR CONCERNED FRIENDS OR FAMILY MEMBERS WHO ARE SEEKING INFORMATION ON DOMESTIC VIOLENCE AND OUR SERVICES. DURING THE YEAR, WE HELPED 1,519 CALLERS TO OUR CRISIS LINE WITH SUPPORTIVE/CARING LISTENING/COUNSELING, INFORMATION, REFERRALS, AND ADVICE.

4b	(Code: ) (Expenses $ 497,033 including grants of $ ) (Revenue $ 146,099 )
	SUPPORTIVE HOUSING & TRANSITIONAL LIVING - A SAFE PLACE PROVIDES BOTH TRANSITIONAL/SCATTERED SITE AND PERMANENT SUPPORTIVE HOUSING TO TENANTS/SURVIVORS OF DOMESTIC VIOLENCE AND THEIR CHILDREN. ALONG WITH AFFORDABLE HOUSING, THE TENANTS RECEIVE SUPPORTIVE SERVICES INCLUDING DOMESTIC VIOLENCE SUPPORT GROUPS, LIFE SKILLS TRAINING, AND COUNSELING SERVICES PROVIDED THROUGH AND REPORTED UNDER OUR COUNSELING, LIFE SKILLS, AND CASE MANAGEMENT PROGRAM. FOR FY18, WE PROVIDED (1) 31,465 NIGHTS OF AFFORDABLE, SAFE HOUSING IN 40 PERMANENT SUPPORTIVE HOUSING APARTMENTS TO 53 WOMEN AND 79 CHILDREN AND (2) 17,461 NIGHTS OF SCATTERED SITE/TRANSITIONAL LIVING THROUGH RENTAL ASSISTANCE WAS PROVIDED TO 22 WOMEN AND 28 KIDS IN HOMES/APARTMENTS THROUGHOUT LAKE COUNTY.

4c	(Code: ) (Expenses $ 622,882 including grants of $ ) (Revenue $ )
	COUNSELING, LIFE SKILLS & CASE MANAGEMENT - THERAPISTS, COUNSELORS AND ADVOCATES PROVIDED 11,944 HOURS OF CASE MANAGEMENT, ADVOCACY, COUNSELING/THERAPY, ART THERAPY, AND LIFE SKILLS TRAINING SERVICES TO 688 ADULT SURVIVORS AND 285 CHILD WITNESSES. THESE SERVICES WERE PROVIDED IN ENGLISH AND SPANISH IN BOTH GROUP AND INDIVIDUAL SETTINGS. SPECIALIZED ART THERAPY IS ALSO PROVIDED TO CHILDREN AND FAMILIES. SURVIVORS SERVED INCLUDED THOSE RESIDING IN OUR SUPPORTIVE HOUSING PROGRAMS. OUR SUPPORTIVE HOUSING/TRANSITIONAL LIVING STAFF PROVIDED 4,607 HOURS OF COUNSELING AND ECONOMIC, EDUCATIONAL, HOUSING, AND OTHER LIFE SKILLS TRAINING TO OVER 182 RESIDENTS OF OUR SUPPORTIVE HOUSING PROGRAM TO HELP SURVIVORS TRANSITION TO INDEPENDENT AND SAFE LIVES.

	(Code: ) (Expenses $ 874,121 including grants of $ ) (Revenue $ 52,797 )
	FAMILY VISITATIONS AND EXCHANGES - A SAFE PLACE'S FAMILY VISITATION CENTER SUPERVISED AND FACILITATED 1,270 CUSTODY EXCHANGES AND 1,003 VISITATIONS, WITH SAFETY OF CHILDREN AND SURVIVORS AS THE PRIMARY CONCERN. DURING THE YEAR, 116 FAMILIES (WITH 184 CHILDREN) WERE SERVED. 81% OF CASES INVOLVE FAMILIES IMPACTED BY DOMESTIC VIOLENCE, WITH THE MAJORITY OF THE REMAINING FAMILIES IMPACTED BY CHILD ABUSE. (OTHER CASES INVOLVE SEXUAL ASSAULT AND STALKING. LEGAL ADVOCACY - OUR LEGAL ADVOCACY PROGRAM, LOCATED IN THE LAKE COUNTY COURTHOUSE PROVIDED ASSISTANCE TO 1,724 SURVIVORS SEEKING ORDERS OF PROTECTION FOR DOMESTIC VIOLENCE. OUR LEGAL ADVOCACY TEAM ASSISTED SURVIVORS IN OBTAINING 1417 EMERGENCY, 8 INTERIM AND 9 PLENARY DOMESTIC VIOLENCE ORDERS OF PROTECTION. IN ADDITION, WE ASSISTED 600 PEOPLE TO OBTAIN ORDERS OF PROTECTION RELATED TO SEXUAL ASSAULT, AND STALKING/NO- CONTACT. THROUGH THE STAFF, INCLUDING SEVERAL VOLUNTEERS, OVER 2,547 HOURS OF ADVOCACY WAS PROVIDED TO SURVIVORS. OUTREACH & EDUCATION - WE WORK TO EDUCATE THE COMMUNITY ABOUT THE DYNAMICS AND EFFECTS OF DOMESTIC VIOLENCE, AND ADVOCATE FOR SURVIVORS, WHILE RAISING AWARENESS OF THE SERVICES THAT ARE AVAILABLE THROUGH MULTIPLE OUTREACH EFFORTS BY STAFF MEMBERS DEDICATED TO OUR EDUCATION PROGRAMS AS WELL AS THROUGH STAFF MEMBERS FROM EVERY AREA OF OUR AGENCY. EDUCATION AND OUTREACH ARE PROVIDED AT BUSINESSES, RELIGIOUS INSTITUTIONS AND OTHER COMMUNITY GATHERINGS. WE ALSO EDUCATE PROFESSIONALS SUCH AS SOCIAL WORKERS OR LAW ENFORCEMENT OFFICIALS WHO MAY COME IN CONTACT WITH DOMESTIC VIOLENCE SURVIVORS. WE PROVIDED OVER 463 HOURS OF EDUCATION AND TRAINING THROUGH 295 PRESENTATIONS REACHING 16,353 PEOPLE. TO ADDRESS THE ISSUES OF TEEN DATING VIOLENCE, A SAFE PLACE ALSO FACILITATES HEALTHY DATING PRESENTATIONS AT LOCAL SCHOOLS AND AGENCIES TO EDUCATE YOUTH AND TEENS. 23 OF THESE PRESENTATIONS, WHICH WORK TO PREVENT DOMESTIC VIOLENCE THROUGH EDUCATION ON RED FLAGS, ABUSIVE DYNAMICS AND THE OPTIONS AVAILABLE FOR TEENS, WERE PROVIDED TO 812 YOUTHS DURING THE YEAR. ABUSER SERVICES - IPDAV - WE ALSO WORK TO ELIMINATE DOMESTIC VIOLENCE AND INCREASE THE SAFETY OF SURVIVORS BY WORKING DIRECTLY WITH ABUSERS. OUR ABUSER INTERVENTION PROGRAM PROVIDED 2,388 HOURS OF COUNSELING THROUGH A SIX-MONTH PROGRAM TO 79 PERPETRATORS OF ABUSE, TEACHING THEM ACCOUNTABILITY AND HELPING THEM TO EXAMINE AND CHANGE THEIR ABUSIVE BEHAVIORS. EACH PARTICIPANT IS INDIVIDUALLY ASSESSED BEFORE BEING PLACED INTO A WEEKLY GROUP. 77 CLIENTS RECEIVED VIOLENCE/BEHAVIORAL ASSESSMENTS DURING THE YEAR. VIOLENCE PREVENTION - SAFE YOUTH, SAFER LAKE COUNTY - THROUGH THE SAFE YOUTH-SAFER LAKE COUNTY PROGRAM, EDUCATION OUTREACH COORDINATORS, THERAPISTS, AND CASE MANAGERS PROVIDE SPECIALIZED VIOLENCE REDUCTION SERVICES TO WAUKEGAN MIDDLE- AND HIGH-SCHOOL STUDENTS. DURING THE YEAR, SAFE YOUTH OFFERED SERVICES IN 5 MIDDLE SCHOOLS AND 2 HIGH SCHOOLS TO PROVIDE 7,101 STUDENTS WITH PREVENTION EDUCATION FOCUSING ON: HEALTHY RELATIONSHIPS/TEEN DATING VIOLENCE; DECISION MAKING/DRUGS AND ALCOHOL; AND INTERNET SAFETY. AS A RESULT OF THIS PREVENTION EDUCATION, 106 CHILDREN RECEIVED BEHAVIORAL HEALTH SERVICES, 41 CHILDREN RECEIVED STREET INTERVENTION/INTERRUPTION SERVICES AND 162 RECEIVED RESOURCES AND ADVOCACY THROUGH CASE MANAGEMENT SERVICES. THROUGH PUBLIC AWARENESS EFFORTS THROUGHOUT THE COMMUNITY, WE MADE CONTACT WITH 45,506 COMMUNITY MEMBERS TO EDUCATE THEM ABOUT VIOLENCE PREVENTION, HEALTHY RELATIONSHIPS, AND THE SAFE YOUTH-SAFER LAKE COUNTY SERVICES BEING OFFERED IN THE WAUKEGAN MIDDLE AND HIGH SCHOOLS.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 874,121 including grants of $ ) (Revenue $ 52,797 )
4e	Total program service expenses2,722,331

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	209,635	13,915

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization

1	Briefly describe the organization’s mission or most significant activities: A SAFE PLACE IS THE SOLE PROVIDER OF SERVICES EXCLUSIVELY ADDRESSING DOMESTIC VIOLENCE AND HUMAN TRAFFICKING IN LAKE COUNTY, ILLINOIS. GUIDED BY THE MISSION OF BEING THE LEADING (SEE CONTINUATION ON ATTACHMENT O)
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	58
6	Total number of volunteers (estimate if necessary) .............	6	500
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b

1a	Federated campaigns..		1a	36,120
b	Membership dues..		1b
c	Fundraising events..		1c	337,432
d	Related organizations		1d	10,065
e	Government grants (contributions)		1e	2,004,676

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,391,059

g	Noncash contributions included in lines 1a - 1f:$		1g	109,291

h Total. Add lines 1a-1f.......		3,779,352

		Business Code
2a	SUPPORTIVE HOUSING RENTS		146,099	146,099
b	ABUSER SERVICE FEES		52,797	52,797
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		198,896

3 Investment income (including dividends, interest, and othersimilar amounts) ......			8,180			8,180
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses		7,014	7b
c	Gain or (loss)		-7,014	7c
d	Net gain or (loss).........			-7,014	-7,014
8a	Gross income from fundraising events (not including $ 337,432of contributions reported on line 1c). See Part IV, line 18 ....
			8a	76,750
b	Less: direct expenses ...		8b	196,318
c	Net income or (loss) from fundraising events..			-119,568
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	MISCELLANEOUS		900099	8,465			8,465
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			8,465
12	Total revenue. See instructions.....			3,868,311	191,882		16,645

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	245,295		245,295
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	1,633,452	1,364,056	58,390	211,006
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	265,953	219,603	13,630	32,720
10	Payroll taxes ...........	132,969	97,806	20,779	14,384
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	3,289		3,289
c	Accounting ...........	24,750		24,750
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	199,808	171,017	12,384	16,407
12	Advertising and promotion ....	58,338	11,758	5,642	40,938
13	Office expenses .......	3,089	604	442	2,043
14	Information technology ......	67,844	48,585	6,405	12,854
15	Royalties ..
16	Occupancy ...........	159,514	158,884	282	348
17	Travel ............	12,643	7,176	3,869	1,598
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	30,462	8,362	21,789	311
20	Interest ...........	51,927	45,794	3,080	3,053
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	224,096	206,180	8,186	9,730
23	Insurance ...	47,498	38,395	7,521	1,582
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	REPAIRS & MAINTENANCE	102,797	97,991	2,114	2,692
b	CLIENT ASSISTANCE	82,947	82,947
c	PROGRAM SUPPLIES	80,964	80,414		550
d	UTILITIES	57,330	54,114	1,434	1,782
e	All other expenses	57,769	28,645	20,284	8,840
25	Total functional expenses. Add lines 1 through 24e	3,542,734	2,722,331	459,565	360,838
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			195,232	1	528,346
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......			712,302	3	761,752
4	Accounts receivable, net .............				4
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........			133,823	7	158,864
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......			72,151	9	121,165
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	6,818,495
b	Less: accumulated depreciation	10b	2,790,161	4,000,289	10c	4,028,334
11	Investments—publicly traded securities .			15,974	11	18,689
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			96,888	13	96,888
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........				15
16	Total assets. Add lines 1 through 15 (must equal line 33)...			5,226,659	16	5,714,038

17	Accounts payable and accrued expenses .....	294,108	17	468,106
18	Grants payable ...		18
19	Deferred revenue .........		19	11,195
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	989,458	23	964,299
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	8,903	25	8,109
26	Total liabilities. Add lines 17 through 25..	1,292,469	26	1,451,709

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	3,934,190	32	4,262,329
33	Total liabilities and net assets/fund balances ........	5,226,659	33	5,714,038